Intake Forms

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Prior to your first evaluation appointment, we ask you to complete the necessary intake documents (see bottom of this page).  For families submitting to medical insurance for reimbursement, your pediatrician may also complete paperwork.  
 
If you are paying for services by credit card, we will have you fill out a recurring payment authorization. Having your authorization on file makes the billing and reimbursement process as seamless as possible. 


Forms to Fill Out Digitally

 
 

Forms to Download, Print and Sign and Bring to Your First Visit

    CREDIT CARD AUTHORIZATION

   CREDIT CARD AUTHORIZATION

          PHYSICIAN PRESCRIPTION

         PHYSICIAN PRESCRIPTION

          MEDICAL RELEASE FORM

         MEDICAL RELEASE FORM